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Bimouhen A, Regragui Z, El Falaki F, Ihazmade H, Benkerroum S, Cherkaoui I, Rguig A, Ezzine H, Benamar T, Triki S, Bakri Y, Oumzil H. Viral aetiology of influenza-like illnesses and severe acute respiratory illnesses in Morocco, September 2014 to December 2016. J Glob Health 2022; 12:04062. [PMID: 35866188 PMCID: PMC9304922 DOI: 10.7189/jogh.12.04062] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background There is a scarcity of information on the viral aetiology of influenza-like illness (ILI) and severe acute respiratory infection (SARI) among patients in Morocco. Methods From September 2014 to December 2016, we prospectively enrolled inpatients and outpatients from all age groups meeting the World Health Organization (WHO) case definition for ILI and SARI from 59 sentinel sites. The specimens were tested using real-time monoplex reverse-transcription polymerase chain reaction method for detecting 16 relevant respiratory viruses. Results At least one respiratory virus was detected in 1423 (70.8%) of 2009 specimens. Influenza viruses were the most common, detected in 612 (30.4%) of processed samples, followed by respiratory syncytial virus (RSV) in 359 (17.9%), human rhinovirus (HRV) in 263 (13.1%), adenovirus (HAdV) in 124 (6.2%), parainfluenza viruses (HPIV) in 107 (5.3%), coronaviruses (HCoV) in 94 (4.7%), human bocavirus (HBoV) in 92 (4.6%), and human metapneumovirus (HMPV) in 74 (3.7%). From 770 samples from children under 5 years old, RSV (288, 36.6%), influenza viruses (106, 13.8%), HRV (96, 12.5%) and HAdV (91, 11.8%) were most prevalent. Among 955 samples from adults, Influenza viruses (506, 53.0%), and HRV (167, 17.5%) were most often detected. Co-infections were found in 268 (18.8%) of 1423 positive specimens, and most (60.4%) were in children under 5 years of age. While influenza viruses, RSV, and HMPV had a defined period of circulation, the other viruses did not display clear seasonal patterns. Conclusions We found that RSV was predominant among SARI cases in Morocco, particularly in children under 5 years of age. Our results are in line with reported data from other parts of the world, stating that RSV is the leading cause of lower respiratory tract infections in infants and young children.
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Affiliation(s)
- Abderrahman Bimouhen
- Laboratory of Human Pathologies Biology, Faculty of Sciences, Mohammed V University in Rabat, Morocco.,National Influenza Center, Virology department, National Institute of Hygiene, Ministry of Health, Morocco
| | - Zakia Regragui
- National Influenza Center, Virology department, National Institute of Hygiene, Ministry of Health, Morocco
| | - Fatima El Falaki
- National Influenza Center, Virology department, National Institute of Hygiene, Ministry of Health, Morocco
| | - Hassan Ihazmade
- National Influenza Center, Virology department, National Institute of Hygiene, Ministry of Health, Morocco
| | - Samira Benkerroum
- National Influenza Center, Virology department, National Institute of Hygiene, Ministry of Health, Morocco
| | - Imad Cherkaoui
- Directorate of Epidemiology and Disease Control, Ministry of Health, Morocco
| | - Ahmed Rguig
- Directorate of Epidemiology and Disease Control, Ministry of Health, Morocco
| | - Hind Ezzine
- Directorate of Epidemiology and Disease Control, Ministry of Health, Morocco
| | - Touria Benamar
- Directorate of Epidemiology and Disease Control, Ministry of Health, Morocco
| | | | - Youssef Bakri
- Laboratory of Human Pathologies Biology, Faculty of Sciences, Mohammed V University in Rabat, Morocco
| | - Hicham Oumzil
- National Influenza Center, Virology department, National Institute of Hygiene, Ministry of Health, Morocco.,Pedagogy and Research Unit of Microbiology, School of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
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Yogurt fortified with vitamins and probiotics impacts the frequency of upper respiratory tract infections but not gut microbiome: A multicenter double-blind placebo controlled randomized study. J Funct Foods 2021. [DOI: 10.1016/j.jff.2021.104572] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
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Ritz T, Salsman ML, Young DA, Lippert AR, Khan DA, Ginty AT. Boosting nitric oxide in stress and respiratory infection: Potential relevance for asthma and COVID-19. Brain Behav Immun Health 2021; 14:100255. [PMID: 33842899 PMCID: PMC8019595 DOI: 10.1016/j.bbih.2021.100255] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/30/2021] [Accepted: 04/01/2021] [Indexed: 01/12/2023] Open
Abstract
Nitric oxide (NO) is a ubiquitous signaling molecule that is critical for supporting a plethora of processes in biological organisms. Among these, its role in the innate immune system as a first line of defense against pathogens has received less attention. In asthma, levels of exhaled NO have been utilized as a window into airway inflammation caused by allergic processes. However, respiratory infections count among the most important triggers of disease exacerbations. Among the multitude of factors that affect NO levels are psychological processes. In particular, longer lasting states of psychological stress and depression have been shown to attenuate NO production. The novel SARS-CoV-2 virus, which has caused a pandemic, and with that, sustained levels of psychological stress globally, also adversely affects NO signaling. We review evidence on the role of NO in respiratory infection, including COVID-19, and stress, and argue that boosting NO bioavailability may be beneficial in protection from infections, thus benefitting individuals who suffer from stress in asthma or SARS-CoV-2 infection.
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Affiliation(s)
- Thomas Ritz
- Department of Psychology, Southern Methodist University, 6116 N. Central Expressway, Suite 1160, Dallas, TX, USA
| | - Margot L Salsman
- Department of Psychology, Southern Methodist University, 6116 N. Central Expressway, Suite 1160, Dallas, TX, USA
| | - Danielle A Young
- Department of Psychology and Neuroscience, Baylor University, One Bear Place, 97334, Baylor Sciences Building, Suite B.309, Waco, TX, USA
| | - Alexander R Lippert
- Department of Chemistry, Southern Methodist University, Fondren Science Building 303, P.O. Box, 750314, Dallas, TX, USA
| | - Dave A Khan
- Department of Internal Medicine, Allergy and Immunology, The University of Texas Southwestern Medical Center, 5323, Harry Hines Blvd., Dallas, TX, USA
| | - Annie T Ginty
- Department of Psychology and Neuroscience, Baylor University, One Bear Place, 97334, Baylor Sciences Building, Suite B.309, Waco, TX, USA
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Cao C, Wang J, Li Y, Li Y, Ma L, Abdelrahim MEA, Zhu Y. Efficacy and safety of OM-85 in paediatric recurrent respiratory tract infections which could have a possible protective effect on COVID-19 pandemic: A meta-analysis. Int J Clin Pract 2021; 75:e13981. [PMID: 33405321 PMCID: PMC7883224 DOI: 10.1111/ijcp.13981] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/27/2020] [Accepted: 01/03/2021] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION The OM-85 (Broncho-Vaxom) consumption has drawn considerable attention in the prevention of recurrent respiratory tract infections. However, it has been reported that the relationship between OM-85 consumption and recurrent respiratory tract infections is variable. This meta-analysis was performed to evaluate this relationship. METHODS A systematic literature search up-to May 2020 was performed and 14 studies were detected with 1859 paediatric subjects, of them 890 consumed OM-85. They were reporting relationships between OM-85 consumption and recurrent respiratory tract infections. Odds ratio (OR) or mean differences (MD) with 95% confidence intervals (CIs) was calculated to evaluate the prognostic role of OM-85 consumption and recurrent respiratory tract infections using the dichotomous or continuous method with a random or fixed-effect model. RESULTS OM-85 consumption was significantly related to lower frequency of respiratory tract infections (MD, -1.16; 95% CI, -1.66 to -0.65, P < .001); lower total duration of respiratory tract infections (MD, -19.51; 95% CI, -23.00 to -16.01, P < .001); lower incidence of respiratory tract infections (OR, 0.40; 95% CI, 0.21-0.77, P = .006); lower number of antibiotic courses (MD, -1.40; 95% CI, -2.63 to 0.17, P = .03); and lower antibiotic use (OR, 0.38; 95% CI, 0.29-0.52, P < .001). However, OM-85 consumption was not significantly related to adverse event rate (OR, 1.02; 95% CI, 0.52-2.03, P = .94); or to wheezing attacks frequency (MD, -0.25; 95% CI, -0.59 to 0.08, P = .14). CONCLUSIONS The impact of OM-85 consumption on recurrent respiratory tract infections may have a great effect as a tool to improve subjects' immunity against recurrent respiratory tract infections, which could be helpful in crucial situations, eg, COVID-19 pandemic. OM-85 non-consumers had an independent risk relationship with recurrent respiratory tract infections. This relationship forces us to recommend OM-85 consumption with those with a high risk of recurrent respiratory tract infections to avoid any possible complications.
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Affiliation(s)
- Changqing Cao
- Department of PediatricsThe First Hospital of Lanzhou UniversityLanzhouP.R. China
| | - Jinghua Wang
- Division of Rheumatology & Allergy in the Department of Pediatricsthe First Hospital of Jilin UniversityChanghunJilinP.R. China
| | - Yuning Li
- Department of PediatricsThe First Hospital of Lanzhou UniversityLanzhouP.R. China
| | - Yumei Li
- Department of PediatricsThe First Hospital of Lanzhou UniversityLanzhouP.R. China
| | - Liyan Ma
- Department of PediatricsThe General Hospital of Ningxia Medical UniversityYinchuanP.R. China
| | | | - Yi Zhu
- Hospital Infection Management OfficeThe Hospital of Xinjiang Production and Construction CorpsWulumuqiP.R. China
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Ge X, Guo Y, Chen J, Hu R, Feng X. Epidemiology and Seasonality of Respiratory Viruses Detected from Children with Respiratory Tract Infections in Wuxi, East China. Med Sci Monit 2018; 24:1856-1862. [PMID: 29599424 PMCID: PMC5892462 DOI: 10.12659/msm.908483] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Respiratory tract infections (RTIs) are the major causes of mortality and morbidity in children and lead to hospitalization in developing countries. However, little is known about the epidemiology and seasonality of respiratory viruses in the pediatric population in Wuxi, East China. Material/Methods We included all patients 14 years of age and below who presented with signs and symptoms of RTIs between January 2010 and December 2016. During this period, a total of 2160 children treated in Wuxi No. 2 People’s Hospital were involved in our study. The clinical and sociodemographic data were recorded to describe the frequency and seasonality. Respiratory specimens were tested by multiplex real-time PCR assays for virus identification. Results More than 30% (35.19%, 760 samples) of the specimens showed evidence of infection with viruses, including respiratory syncytial virus (368 samples), influenza virus A (114 samples), influenza virus B (115 samples), parainfluenza virus I (29 samples), parainfluenza virus II (39 samples), parainfluenza virus III (13 samples), and adenovirus (82 samples); 48.99% of the children infected with viruses were under 12 months of age. Viruses were detected throughout all the year, with a peak in winter. Conclusions Our study found that RSV is the most important cause of RTIs in our region during winter. Our data provide a comprehensive understanding of the epidemiology and seasonality of virus, which may help to reduce the use of antibiotics and implement an effective approach for prevention, control, and treatment of RTIs, especially during its peak season.
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Affiliation(s)
- Xiaoli Ge
- Neonate Department, Children's Hospital of Soochow University, Suzhou, Jiangsu, China (mainland).,Department of Pediatrics, Wuxi Second People's Hospital of Nanjing Medical University, Wuxi, Jiangsu, China (mainland)
| | - Yi Guo
- Department of Pediatrics, Wuxi Second People's Hospital of Nanjing Medical University, Wuxi, Jiangsu, China (mainland)
| | - JuanJuan Chen
- Department of Pediatrics, Wuxi Second People's Hospital of Nanjing Medical University, Wuxi, Jiangsu, China (mainland)
| | - Renjing Hu
- Department of Laboratory Medicine, Wuxi Second People's Hospital of Nanjing Medical University, Wuxi, Jiangsu, China (mainland)
| | - Xing Feng
- Neonate Department, Children's Hospital of Soochow University, Suzhou, Jiangsu, China (mainland)
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Albogami SS, Alotaibi MR, Alsahli SA, Masuadi E, Alshaalan M. Seasonal variations of respiratory viruses detected from children with respiratory tract infections in Riyadh, Saudi Arabia. J Infect Public Health 2017; 11:183-186. [PMID: 28668655 DOI: 10.1016/j.jiph.2017.06.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 03/14/2017] [Accepted: 06/09/2017] [Indexed: 12/25/2022] Open
Abstract
ARTIs have a huge impact in health systems in which 20-30% of all hospital admissions and 30-60% of practitioner visits are related to respiratory tract infections. The aim of this study is to determine the prevalence, age distribution, and seasonal variation of respiratory viruses. This study was descriptive retrospective study in which all patients 14 years of age and below who presented with signs and symptoms of ARTIs between January 2013 and December 2014 and had respiratory specimen tested by direct immunofluorescence assays for viruses identification were included in the study. During that period, a total of 4611 patients who presented with ARTIs from January 2013 to December 2014 were investigated, viruses were detected in 1115 (24%). RSV was associated with 97.4% of the total viral pathogens. Viruses were detected throughout all the two years with a peak in winter; Dec (n: 265), Jan (n: 418), Feb (n: 218), and Mar (n: 109). Viral pathogens are very important cause of ARTIs in our region. RSV was the most common virus detected with the highest detection rate in children who are two years old and below. A multi-center surveillance with more sensitive detection methods like PCR may help to provide a comprehensive understanding of virus distribution in our area, which may contribute implant an effective prevention approach for each virus.
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Mishra KN, Bhardwaj P, Mishra A, Kaushik A. Acute Chlamydia trachomatis respiratory infection in infants. J Glob Infect Dis 2011; 3:216-20. [PMID: 21887051 PMCID: PMC3162806 DOI: 10.4103/0974-777x.83525] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objectives: This designed was designed to estimate the prevalence of Chlamydia trachomatis infection in infants of up to 6 months of age and to assess clinical and laboratory indicators as predictors of Chlamydia etiology. Materials and Methods: A hospital-based study was conducted in Department of Pediatrics, Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh, India, where infants up to 6 months of age (n=50) with features of lower respiratory tract infection of at least 1 week duration and fulfilling the inclusion criteria were assessed clinically and underwent laboratory investigations using hemogram, Chest X-ray, and IgM ELISA. Results: Out of 50 infants, 12 (24%) were tested positive by IgM ELISA test for C. trachomatis infection. In age group of up to 2 months 25% positivity was seen whereas it was found to be 31.81% in age group of 2–4 months and 15% in age group 4–6 months. With the ‘P’ value less than 0.05, it was found that there may be an association of seropositivity of C. trachomatis with duration of cough and absolute eosinophil count. Conclusion: Chlamydia trachomatis is an important cause of lower respiratory tract infection in infants below six months of age. The prolonged duration of cough and increased absolute eosinophil count may be good indicator of its etiology.
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Affiliation(s)
- Kamal Narain Mishra
- Department of Pediatrics, Era's Lucknow Medical College and Hospital, Sarfarazganj, Lucknow, India
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York T, de Wet H, van Vuuren SF. Plants used for treating respiratory infections in rural Maputaland, KwaZulu-Natal, South Africa. JOURNAL OF ETHNOPHARMACOLOGY 2011; 135:696-710. [PMID: 21497646 DOI: 10.1016/j.jep.2011.03.072] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2010] [Revised: 03/28/2011] [Accepted: 03/31/2011] [Indexed: 05/22/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Traditional remedies are frequently used in treating various respiratory ailments, and are very important in the primary health care of the people living in rural Maputaland, KwaZulu-Natal, South Africa. Novel information gathered from surveys like the present study is important in preserving indigenous knowledge. AIM OF THE STUDY To explore the knowledge that the lay people of a rural community in northern Maputaland have about medicinal plants used in the vicinity to treat respiratory infections. MATERIALS AND METHODS Interviews were conducted among 80 homestead inhabitants, using structured questionnaires where convenience sampling was used. The focus was on plants used in treating respiratory infections. Some of the main topics discussed during the interviews were vernacular plant names, plant parts used, harvested amounts, preparation methods, dosage forms and quantities, use of plants in combination as well as the related symptomatic relief associated with respiratory infections. RESULTS The study documented 30 plant species (18 families) which are used to treat respiratory infections by the rural people in the study area. Decoctions made with these plants are mostly taken orally, combined with the use of steaming. To the best of our knowledge, Acanthospermum glabratum, Aloe marlothii, Krauseola mosambicina, Ozoroa obovata, Parinari capensis and Plectranthus neochilus are recorded for the first time globally as medicinal plants used for treating respiratory infections and related symptoms. The indigenous aromatic shrub, Lippia javanica was by far the most frequently used plant species, followed by Eucalyptus grandis (an exotic), Tetradenia riparia and then Senecio serratulloides. Twenty-four different plant combinations were used where the most frequently used combination encountered was Eucalyptus grandis with Lippia javanica. CONCLUSION The large number of different plant species traditionally used against respiratory infections supports previous research on the importance of traditional medicine in the primary health care of this remote area. The finding of new vernacular plant names and plant uses in the current survey shows the importance of the documentation of such ethnobotanical knowledge.
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Affiliation(s)
- T York
- Department of Botany, University of Zululand, Private Bag 1001, KwaDlangezwa 3886, South Africa
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Luque JS, Whiteford LM, Tobin GA. Maternal Recognition and Health Care-Seeking Behavior for Acute Respiratory Infection in Children in a Rural Ecuadorian County. Matern Child Health J 2008. [DOI: 10.1007/s10995-008-0364-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Luque JS, Whiteford LM, Tobin GA. Maternal recognition and health care-seeking behavior for acute respiratory infection in children in a rural Ecuadorian county. Matern Child Health J 2007; 12:287-97. [PMID: 17673964 DOI: 10.1007/s10995-007-0249-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2006] [Accepted: 06/29/2007] [Indexed: 01/01/2023]
Abstract
OBJECTIVES To identify the factors which determine timely health care-seeking behaviors for childhood ARIs. METHODS A semi-structured questionnaire was administered to a non-random purposive sample of 91 female caregivers (age 18-57 years), and was analyzed using SPSS. In addition, six focus group discussions with female caregivers and 25 in-depth interviews with members from the health care setting were conducted. RESULTS The primary obstacles reported for timely health care-seeking among survey respondents were money for medicines (n=29, 32%), transportation fares (n=19, 21%), and restrictive hours of the health centers (n=13, 14%). The median household salary reported was $100 per month. There was an overall lack of recognition of the biomedical signs and symptoms of serious lower respiratory infections independent of socioeconomic status. CONCLUSIONS Based on the study findings, the following recommendations are offered: (1) public health campaigns need to better address appropriate home health care management of childhood health and illness to improve maternal health-seeking behavior for ARIs; (2) provincial health authorities need to adhere to regular hours of operation, expand clinic hours and increase staff; (3) health posts should establish better policies for disbursement of antibiotics and ensure that patients follow prescribed regimens; and (4) through partnerships with economic development organizations and the private sector, there will be increased employment opportunities.
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Affiliation(s)
- John S Luque
- H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, FOW-EDU, Tampa, FL 33612, USA.
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Affiliation(s)
- Mark Steinhoff
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
| | - Robert Black
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
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Arcay JD, Ocampo AF, Solis RK, Oncog IB, Diaz AD, Epe ACC, Cagadas R, Pabatang S, Ostensen H, Lucero MG. Radiology quality assurance in a developing country setting: The 11-valent pneumococcal conjugate vaccine trial, Bohol, Philippines. Vaccine 2007; 25:2528-32. [PMID: 17023097 DOI: 10.1016/j.vaccine.2006.09.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The endpoint used for a phase 3 pneumococcal conjugate vaccine (PCV) trial in Bohol, Philippines was radiographic consolidation. Only one (Bohol Regional Hospital, BRH) of the four surveillance hospitals had a quality control/quality assurance program (QC/QA) prior to the trial. QC/QA was initiated in the three private hospitals. Radiologists from BRH evaluated radiographs from all hospitals based on recommended standards. Four thousand nine hundred and eighty nine films were analyzed. In 2000, the proportion of good quality films was 65% and 29% in BRH and private hospitals, respectively. By 2004, these increased to 92% and 79%, respectively. Poor film quality was commonly due to absence of collimation and poor contrast. The regular QC/QA implementation was necessary to improve film quality and was particularly important in our PCV trial that used X-ray proven consolidation as an endpoint.
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Affiliation(s)
- Jose D Arcay
- Bohol Regional Hospital, Tagbilaran City, Bohol, Philippines.
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Sazawal S, Black RE. Effect of pneumonia case management on mortality in neonates, infants, and preschool children: a meta-analysis of community-based trials. THE LANCET. INFECTIOUS DISEASES 2003; 3:547-56. [PMID: 12954560 DOI: 10.1016/s1473-3099(03)00737-0] [Citation(s) in RCA: 329] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Pneumonia still causes around two million deaths among children annually (20% of all child deaths). Any intervention that would affect pneumonia mortality is of great public health importance. This meta-analysis provides estimates of mortality impact of the case-management approach proposed by WHO. We were able to get data from nine of ten eligible community-based studies that assessed the effects of pneumonia case-management intervention on mortality; seven studies had a concurrent control group. Standardised forms were completed by individual investigators to provide information on study description, quality scoring, follow-up, and outcome (mortality) data with three age groups (<1 month, <1 year, 0-4 years) and two mortality categories (total and pneumonia-specific). Meta-analysis found a reduction in total mortality of 27% (95% CI 18-35%), 20% (11-28%), and 24% (14-33%) among neonates, infants, and children 0-4 years of age, respectively. In the same three groups pneumonia mortality was reduced by 42% (22-57%), 36% (20-48%), and 36% (20-49%). There was no evidence of publication bias and results were unaltered by exclusion of any study. A limitation of the included studies is that they were not randomised and, because of the nature of the intervention, could not be blinded. Community-based interventions to identify and treat pneumonia have a substantial effect on neonatal, infant, and child mortality and should be incorporated into primary health care.
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Affiliation(s)
- Sunil Sazawal
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
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Wilde JA. Rapid diagnostic testing for the identification of respiratory agents in the emergency department. CLINICAL PEDIATRIC EMERGENCY MEDICINE 2002. [DOI: 10.1053/epem.2002.128769] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Bell JM, Turnidge JD, Jones RN. Antimicrobial resistance trends in community-acquired respiratory tract pathogens in the Western Pacific Region and South Africa: report from the SENTRY antimicrobial surveillance program, (1998-1999) including an in vitro evaluation of BMS284756. Int J Antimicrob Agents 2002; 19:125-32. [PMID: 11850165 DOI: 10.1016/s0924-8579(01)00475-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
From 1998 to 1999, a large number of community-acquired respiratory tract isolates of Streptococcus pneumoniae (n=566), Haemophilus influenzae (n=513) and Moraxella catarrhalis (n=228) were collected from 15 centres in Australia, Hong Kong, Japan, China, the Philippines, Singapore, South Africa and Taiwan through the SENTRY Antimicrobial Surveillance Program. Isolates were tested against 26 antimicrobial agents using the NCCLS-recommended methods. Overall, 40% of S. pneumoniae isolates were resistant to penicillin with 18% of strains having high-level resistance (MIC > or =2 mg/l). Rates of erythromycin and clindamycin resistance were 41 and 23%, respectively. Penicillin-resistant strains showed high rates of resistance to other antimicrobial agents: 96% to trimethoprim-sulphamethoxazole (TMP-SMX), 84% to tetracycline and 81% to erythromycin. A significant proportion of penicillin-susceptible strains was also resistant to erythromycin (21%), tetracycline (29%) and TMP-SMZ (26%). Small numbers of strains were resistant to levofloxacin (0.7%), trovafloxacin (0.4%) and grepafloxacin (1.3%) where as all strains remained uniformly susceptible to quinupristin/dalfopristin and BMS284756 (MIC(90), 0.06 mg/l), a new desfluoroquinolone. beta-lactamases were, produced by 20% H. influenzae isolates and only rare strains showed intrinsic resistance to amoxycillin. Other beta-lactam agents showed good activity with rates of resistance less than 2% and all isolates showed susceptibility to cefixime, ceftibuten, cefepime and cefotaxime. Rates of resistance to tetracycline and chloramphenicol were also relatively low at 3%. The majority (98%) of M. catarrhalis isolates was found to be beta-lactamase-positive and resistant to penicillins, however, resistance to erythromycin and tetracycline was also low at 1.8%. Both H. influenzae and M. catarrhalis isolates were uniformly susceptible to the new desfluoroquinolone and tested fluoroquinolones.
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Di Fabio JL, Castañeda E, Agudelo CI, De La Hoz F, Hortal M, Camou T, Echániz-Avilés G, Noemi M, Barajas C, Heitmann I, Hormazabal JC, Brandileone MC, Dias Vieira VS, Regueira M, Ruvinski R, Corso A, Lovgren M, Talbot JA, De Quadros C. Evolution of Streptococcus pneumoniae serotypes and penicillin susceptibility in Latin America, Sireva-Vigía Group, 1993 to 1999. PAHO Sireva-Vigía Study Group. Pan American Health Organization. Pediatr Infect Dis J 2001; 20:959-67. [PMID: 11642630 DOI: 10.1097/00006454-200110000-00009] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Since 1993 the Pan American Health Organization has coordinated a surveillance network with the National Reference Laboratories of Argentina, Brazil, Chile, Colombia, Mexico and Uruguay aimed at monitoring capsular types and antimicrobial susceptibility of Streptococcus pneumoniae causing invasive disease in children <6 years of age. METHODS The surveillance system included children 6 years of age and younger with invasive disease caused by S. pneumoniae. The identification, capsular typing and susceptibility to penicillin of the isolates were conducted using a common protocol, based on standard methodologies. RESULTS By June, 1999, 4,105 invasive pneumococcal isolates had been collected mainly from pneumonia (44.1%) and meningitis (41.1%) cases. Thirteen capsular types accounting for 86.1% of the isolates (14, 6A/6B, 5, 1, 23F, 19F, 18C, 19A, 9V, 7F, 3, 9N and 4) remained the most common types during the surveillance period. Diminished susceptibility to penicillin was detected in 28.6% of the isolates, 17.3% with intermediate and 11.3% with high level resistance. Resistance varied among countries and increased during this period in Argentina, Colombia and Uruguay. Serotypes 14 and 23F accounted for 66.6% of the resistance. CONCLUSION These surveillance data clearly demonstrate the potential impact of the introduction of a conjugate vaccine on pneumococcal disease and the need for more judicious use of antibiotics to slow or reverse the development of antimicrobial resistance.
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Affiliation(s)
- J L Di Fabio
- Division of Vaccines and Immunization, Pan American Health Organization, Washington, DC, USA
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Chuc NT, Larsson M, Falkenberg T, Do NT, Binh NT, Tomson GB. Management of childhood acute respiratory infections at private pharmacies in Vietnam. Ann Pharmacother 2001; 35:1283-8. [PMID: 11675861 DOI: 10.1345/aph.10313] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To investigate the knowledge and practice among private pharmacy staff in Hanoi regarding case management of mild acute respiratory infection (ARI) in children. METHODS Sixty private pharmacies in Hanoi were randomly selected. Knowledge was assessed through interviews with pharmacy staff using a questionnaire; practice was assessed through the Simulated Client Method. RESULTS In the questionnaire, 20% of the pharmacy staff stated that they would dispense antibiotics. In practice, 83% of the pharmacies dispensed antibiotics. Only 36% of the cases were handled according to guidelines. In the questionnaire, 81% of interviewees stated that antibiotics are not effective in short therapeutic courses. In practice, 48% of the antibiotics were dispensed in courses less than five days. Traditional herbal medicines were dispensed in 41% of the encounters. In the questionnaire, 53% of the pharmacy staff stated that they would ask the patient about difficulty of breathing. In practice, questions related to difficulty of breathing were asked in less than 10% of the encounters. CONCLUSIONS Dispensing of antibiotics for mild ARI was common practice among private pharmacies, and there was a significant difference between knowledge and practice. Interventions are needed to improve pharmacy practice in Hanoi.
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Affiliation(s)
- N T Chuc
- Hanoi Medical University, Division of International Health, Vietnam.
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Haltiwanger KA, Hayden GF, Weber T, Evans BA, Possner AB. Antibiotic-seeking behavior in college students: what do they really expect? JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2001; 50:9-13. [PMID: 11534753 DOI: 10.1080/07448480109595705] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Injudicious use of antibiotics contributes to increased bacterial resistance, and patient expectations encourage physicians to overuse antibiotics. The authors evaluated the level of ill college students' antibiotic-seeking behavior to determine if receiving an antibiotic prescription influenced patients' satisfaction with visits to a clinician. Of 129 students with upper respiratory complaints presenting to a university health center, 55% expected an antibiotic prescription. Antibiotic expectation was significantly more likely among students who thought they had a bacterial versus a viral infection (90% vs 40%; p < .01). A clear diagnosis, an explanation of the rationale for treatment, and an antibiotic prescription were significantly associated with patient satisfaction. Clinicians prescribed an antibiotic for 36% of the students; only 13% of these 46 had requested an antibiotic during the visit. At some previous time, one third of the students had taken an antibiotic prescribed for an earlier illness or for another person. Better patient education and improved clinician-patient communication can potentially help to reduce the injudicious use of antibiotics.
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Affiliation(s)
- K A Haltiwanger
- University of Virginia Health System in Charlottesville, Department of Pediatrics, 22908-0386, USA
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Talan DA. Clinical perspectives on new antimicrobials: focus on fluoroquinolones. Clin Infect Dis 2001; 32 Suppl 1:S64-71. [PMID: 11249831 DOI: 10.1086/319378] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Respiratory tract infections are the most common infectious presentation in the community and hospital settings and are a major cause of morbidity and mortality worldwide. Recently, newer fluoroquinolones have been recommended for the treatment of these infections. Among them, moxifloxacin shows improved activity against gram-positive pathogens, has maintained potency against gram-negative organisms, and shows activity against atypical pathogens and anaerobes. Moxifloxacin also has excellent in vitro activity against strains resistant to penicillin, erythromycin, and other fluoroquinolones, such as levofloxacin. Moxifloxacin has demonstrated clinical efficacy rates of 90%-95% in clinical trials in community-acquired pneumonia, acute exacerbations of chronic bronchitis, and acute sinusitis. In these trials, moxifloxacin demonstrated no serious or unexpected adverse effects. Development of resistance appears to be slower for moxifloxacin than for several other fluoroquinolones, making moxifloxacin a good treatment choice. The pharmacodynamics of moxifloxacin support once-daily oral therapy of short duration, providing convenience, compliance, and safety advantages.
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Affiliation(s)
- D A Talan
- Department of Medicine, Divisions of Emergency Medicine and Infectious Diseases, University of California, Los Angeles, CA, USA
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Leach AJ. Multidrug-resistant Streptococcus pneumoniae: An opportunity to further understand pneumococcal ecology and to better predict intervention outcomes. Clin Infect Dis 1999; 29:1265-7. [PMID: 10524973 DOI: 10.1086/313494] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Affiliation(s)
- S M Ostroff
- National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA
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